Capacity building to improve women's health in rural China

The Women's Reproductive Health and Development Program (WRDHP) is an ambit ious attempt to operationalize two important tenets of health development t hinking within a rural reproductive health context. First, it is important for communities to participate in decisions about the services and programs that affect them. Secondly, the complex nature of healthcare is best addre ssed by intervention processes which call for a multi-functional approach t o planning and coordination. In both planning and intervention approach, th e WRHDP recognizes the social, cultural and economic realities that affect women's efforts to secure the health and well-being of themselves and their families. The focus of the WRHDP is on capacity-building within a rural re productive health environment, in this case Yunnan Province in rural China. Rather than using international donor funding to provide a specific interv ention, the WRDHP used Ford Foundation funding as a lever to encourage comm unity investment in environmental resources that affect health, to improve the technical skills of individuals within the existing health bureaucracie s, and to promote structural changes within existing health and development bureaucracies to support interagency collaboration and community empowerme nt within the region's health and development agencies. This article descri bes how the WRHDP created new methods for provincial and local agencies to overcome obstacles and work with one another to improve women's health. It also describes the processes used in the rural areas of Chengjiang and Luli ang counties to assess local conditions and needs, and the supported and ex panded local efforts in improving woman's reproductive and family health th at resulted from the processes. (C) 2000 Elsevier Science Ltd. All rights r eserved.